Constipation is the inability to pass stools, or the passage of hard, dry stools. The National Institute of Diabetes and Digestive and Kidney Diseases defines constipation as having a bowel movement less than three times in a week. Constipation is not a disease, but a symptom of nutritional deficiencies or a medical condition.
Considerations
A person with abdominal distention and chronic constipation could be suffering from an intestinal obstruction. According to the Merck Manuals, causes of intestinal obstruction include a hernia; volvulus, an abnormal twisting of the bowel; adhesions, which is scarring of the intestines against the abdominal wall following abdominal surgery; and fecal impaction, in which a hard piece of stool blocks the intestine.
Symptoms
The symptoms of constipation include abdominal pain and distension, pain when attempting to have a bowel movement, straining that can result in the passage of blood in the stools, and the feeling of incomplete passage of stools. People with fecal impaction can have cramps, feel a mass in their lower abdomen, and pass watery stools around the impacted mass, a process called paradoxical diarrhea.
Causes
Constipation can be caused by having a diet low on fiber-rich foods such as fruits and vegetables, and as a result of poor fluid intake or dehydration. But constipation and abdominal distention also can be caused by serious medical conditions. Colon cancer can initially present as abdominal distension and constipation. Metabolic problems such as hypothyroidism and diabetes can cause chronic constipation. Other conditions associated with old age, such as Parkinson's disease and stroke. also can predispose to constipation and abdominal distension.
Testing
The diagnosis of constipation is based on the symptoms. If there is suspicion of an obstruction, X-rays, including CT scans or a barium enema, might help assess the severity of the blockage. Blood tests might be necessary to diagnose conditions such as hypothyroidism. Direct visualization of the large intestine with a colonoscopy helps in the diagnosis of colon cancer.
Treatment
Once serious causes of constipation and abdominal distention are ruled out, treatment of constipation involves nutritional changes and medical management. Changes in the diet include increasing the amount of fruits, vegetables and bran-containing products, such as cereals. Medical treatment with laxatives and stool softeners also can relieve the symptoms of constipation.
